POSITIONING GUIDE
D I G I TA L IMAGING GUIDELINES
Chest/Ribs
PA - Erect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Lateral - Erect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
AP Stretcher - Erect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
PA Stretcher - Erect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
AP Wheelchair - Erect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
PA Wheelchair - Erect. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Lateral Decubitus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
AP Lordotic - Erect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Ribs RAO - Standing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Abdomen
AP Supine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
AP- Erect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Left Lateral Decubitus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Upper Limb
Hand PA - Standing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Elbow - Seated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Shoulder
AP - Standing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Axial - Standing (Right) . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Axial - Standing (Left) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Axial - Seated (Right) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Axial - Seated (Left) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Axial - Supine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Clements Modification . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Lower Limb
Foot AP - Seated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
AP Bilateral Feet (Weight - Bearing) . . . . . . . 30
Lateral Foot (Weight - Bearing) . . . . . . . . . . . . . . . 31
Calcaneus - Axial (Seated). . . . . . . . . . . . . . . . . . . . . . . . 32
Ankle Lateral - Seated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
AP Bilateral Knees (Weight - Bearing) . . . 34
PA Bilateral Knees (Rosenberg Method) . 35
Sunrise / Skyline - Supine 40” . . . . . . . . . . . . . . . . . 36
Sunrise / Skyline - Supine 72” . . . . . . . . . . . . . . . . . 37
Sunrise / Skyline - Seated . . . . . . . . . . . . . . . . . . . . . . . . . 38
Sunrise / Skyline - Prone
(Hughston Method) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Femur AP - Supine. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Pelvic Girdle
Pelvis AP - Supine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Hip Frog - Leg Lateral . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Hip Lateral - Standing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Left Hip Cross - Table Lateral 40” . . . . . . . . . . . 45
Left Hip Cross - Table Lateral 72” . . . . . . . . . . . 46
Left Hip Cross - Table Lateral 40” . . . . . . . . . . . 47
Right Hip Cross - Table Lateral 72” . . . . . . . . 48
Sacroiliac Joint - LPO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Sacroiliac Joint - RPO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
Cervical Spine
AP - Standing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Lateral - Standing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Swimmer’s Lateral . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Lumbar Spine, Sacrum
Lumbar Spine Cross - Table Lateral . . . . . . . . . 56
Sacrum AP Supine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Skull
Waters - Standing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Reverse Towne - Seated . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Submentovertex (SMV) . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Off Centre Positioning
Shoulder Axial - Supine. . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Shoulder Clements Modification . . . . . . . . . . . . . 27
Lower Limb Sunrise / Skyline Seated . . . . . . . 38
Pelvic Girdle Left Hip. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Digital Imaging Guidelines
Making the Transition to DR . . . . . . . . . . . . . . . . . . 63
Grid Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
Collimation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
Correct Exposure Indication . . . . . . . . . . . . . . . . . . . . 64
Unassigned Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Underexposure Flowchart . . . . . . . . . . . . . . . . . . . . . . . . 65
Overexposure Flowchart . . . . . . . . . . . . . . . . . . . . . . . . . . 66
 Chest/Ribs
CHEST/RIBS
 CHEST
O
DETECTOR: 90 | CENTRAL RAY: ⊥

PA - E R E C T

4
 CHEST
O
DETECTOR: 90 | CENTRAL RAY: ⊥

L AT E R A L - E R E C T

5
 CHEST
O O
DETECTOR: 90 | CENTRAL RAY: +3

A P S T R E T C H E R - E R E CT

6
 CHEST
O
DETECTOR: 90 | CENTRAL RAY: ⊥

PA S T R E T C H E R - E R E CT

7
 CHEST
O O
DETECTOR: 82 | CENTRAL RAY: +3

A P W H E E L C H A I R - E R ECT

8
 CHEST
O
DETECTOR: 90 | CENTRAL RAY: ⊥

PA W HE E L C H A I R - E R ECT

9
 CHEST
O
DETECTOR: 90 | CENTRAL RAY: ⊥

L AT E R A L D E C U B I T U S

10
 CHEST
O O
DETECTOR: 90 | CENTRAL RAY: -15

AP LORDOTIC - ERECT

11
 RIBS
O
DETECTOR: 90 | CENTRAL RAY: ⊥

R A O - S TA N D I N G

12
 Abdomen
ABDOMEN
ABDOMEN
O
DETECTOR: 0 | CENTRAL RAY: ⊥

AP - SUPINE

14
ABDOMEN
O
DETECTOR: 90 | CENTRAL RAY: ⊥

AP - ERECT

15
 ABDOMEN
O
DETECTOR: 90 | CENTRAL RAY: ⊥

L E F T L AT E R A L D E C U B I TUS

16
UPPER LIMB

Upper Limb
 UPPER LIMB
O
DETECTOR: 90 | CENTRAL RAY: ⊥

HAND PA - STANDING

18
 UPPER LIMB
O
DETECTOR: 0 | CENTRAL RAY: ⊥

ELBOW - SEATED

19
 Shoulder
SHOULDER
 SHOULDER
O
DETECTOR: 90 | CENTRAL RAY: ⊥

AP - STANDING

21
 SHOULDER
O
DETECTOR: 90 | CENTRAL RAY: ⊥

AXIAL - STANDING (RIGHT)

22
 SHOULDER
O
DETECTOR: 90 | CENTRAL RAY: ⊥

AXIAL - STANDING (LEFT)

23
 SHOULDER
O O
DETECTOR: 30 | CENTRAL RAY: + 5

AXIAL - SEATED (RIGHT)

24
 SHOULDER
O O
DETECTOR: 30 | CENTRAL RAY: + 5

AXIAL - SEATED (LEFT)

25
 SHOULDER
O O
DETECTOR: 90 | CENTRAL RAY: + 5

AXIAL - SUPINE LAWRENCE METHOD (OFF CENTRE POSITIONING)

26
 SHOULDER
O O
DETECTOR: 90 | CENTRAL RAY: + 2

CLEMENTS MODIFICATION OFF CENTRE POSITIONING

27
 Lower Limb
LOWER LIMB
 LOWER LIMB
O O
DETECTOR: 45 | CENTRAL RAY: + 10

FOOT AP - SEATED

29
 LOWER LIMB
O O
DETECTOR: 0 | CENTRAL RAY: + 10

AP BILATERAL FEET WEIGHT-BEARING

30
LOWER LIMB
O
DETECTOR: 90 | CENTRAL RAY: ⊥

LATERAL FOOT WEIGHT-BEARING

31
 LOWER LIMB
O O
DETECTOR: 0 | CENTRAL RAY: -40

CALCANEUS - AXIAL (SEATED)

32
 LOWER LIMB
O
DETECTOR: 0 | CENTRAL RAY: ⊥

ANKLE LATERAL - SEATED

33
 LOWER LIMB
O
DETECTOR: 90 | CENTRAL RAY: ⊥

AP BILATERAL KNEES WEIGHT-BEARING

34
 LOWER LIMB
O O
DETECTOR: 90 | CENTRAL RAY: +10

PA BILATERAL KNEES ROSENBERG METHOD

35
 LOWER LIMB
O
DETECTOR: 70 | CENTRAL RAY: ⊥ | SID: 40”

SUNRISE/SKYLINE - SUPINE SUPEROINFERIOR PROJECTION

36
 LOWER LIMB
O
DETECTOR: 70 | CENTRAL RAY: ⊥ | SID: 72”

SUNRISE/SKYLINE - SUPINE SUPEROINFERIOR PROJECTION

37
 LOWER LIMB
O O
DETECTOR: 90 | CENTRAL RAY: +10

SUNRISE/SKYLINE - SEATED SUPEROINFERIOR PROJECTION (OFF CENTRE POSITIONING)

38
 LOWER LIMB
O O
DETECTOR: 0 | CENTRAL RAY: -45

SUNRISE/SKYLINE - PRONE HUGHSTON METHOD

39
 LOWER LIMB
O
DETECTOR: 0 | CENTRAL RAY: ⊥

FEMUR AP - SUPINE

40
PELVIC GIRDLE

Pelvic Girdle
 P E LV I C G I R D L E
O
DETECTOR: 0 | CENTRAL RAY: ⊥

PELVIS AP - SUPINE

42
 P E LV I C G I R D L E
O
DETECTOR: 90 | CENTRAL RAY: ⊥

HIP FROG-LEG LATERAL STANDING

43
 P E LV I C G I R D L E
O O
DETECTOR: 90 | CENTRAL RAY: -12

HIP LATERAL - STANDING

44
P E LV I C G I R D L E
O
DETECTOR: 90 | CENTRAL RAY: ⊥ | SID: 40”

LEFT HIP CROSS-TABLE LATERAL

45
P E LV I C G I R D L E
O
DETECTOR: 90 | CENTRAL RAY: ⊥ | SID: 72”

LEFT HIP CROSS-TABLE LATERAL

46
P E LV I C G I R D L E
O O
DETECTOR: 90 | CENTRAL RAY: +2 | SID: 40”

LEFT HIP CROSS-TABLE LATERAL (OFF CENTRE POSITIONING)

47
P E LV I C G I R D L E
O
DETECTOR: 90 | CENTRAL RAY: ⊥ | SID: 72”

RIGHT HIP CROSS-TABLE LATERAL

48
 P E LV I C G I R D L E
O
DETECTOR: 0 | CENTRAL RAY: ⊥

SACROILIAC JOINT - LPO

49
 P E LV I C G I R D L E
O
DETECTOR: 0 | CENTRAL RAY: ⊥

SACROILIAC JOINT - RPO

50
 Cervical Spine
CERVICAL SPINE
CERVICAL SPINE
O O
DETECTOR: 90 | CENTRAL RAY: -15

AP - STANDING

52
 CERVICAL SPINE
O
DETECTOR: 90 | CENTRAL RAY: ⊥

LATERAL - STANDING

53
 CERVICAL SPINE
O
DETECTOR: 90 | CENTRAL RAY: ⊥

SWIMMER’S LATERAL STANDING

54
Lumbar Spine, Sacrum
LUMBAR SPINE,
SACRUM
 LUMBAR SPINE
O
DETECTOR: 90 | CENTRAL RAY: ⊥

CROSS-TABLE LATERAL

56
SACRUM
O O
DETECTOR: 0 | CENTRAL RAY: -15

AP SUPINE

57
SKULL

Skull
 SKULL
O
DETECTOR: 90 | CENTRAL RAY: ⊥

WATERS - STANDING

59
 SKULL
O
DETECTOR: 90 | CENTRAL RAY: ⊥

REVERSE TOWNE - SEATED

O
-25 FOR HAAS METHOD

60
 SKULL
O
DETECTOR: 115 | CENTRAL RAY: ⊥

SUBMENTOVERTEX (SMV) SEATED

61
 Guidelines
DIGITAL IMAGING
GUIDELINES
 D I G I TA L IMAGING GUIDELINES

Making the Transition to DR Grid Use

Technologists require the same basic radiographic skills with a
new understanding of digital radiography.
Dark images are not necessarily overexposed.
Light images are not necessarily underexposed.
It is best to keep the anatomy centreed to the detector for
optimal image processing but with the Xplorer detector, any
part of the image receptor area may be used.
Lead blockers should be used to prevent direct exposure to
the image receptor for high exposures such as lateral lumbar
spines.
Use appropriate kVp to penetrate anatomy.
When using AEC, position carefully to ensure adequate
penetration.
Scatter radiation is decreased when using a grid. This helps to
maximize image detail and contrast.
Use the standard 10 cm rule for grid use. Use a grid for
anatomy thicker than 10 cm.
Ensure the grid is removed prior to imaging small body parts
such as hands and feet.
The principle is the same as film/screen imaging; exams
typically performed ‘table top’ or directly on a cassette should
be performed without a grid.
Collimation
Collimation is especially important for the image processing to
work well.
The image processing software calculates everything within the
collimated field.
Use the standard practice of collimation to the area of interest
on each exposure.

63
 D I G I TA L IMAGING GUIDELINES

Correct exposure indication Unassigned images

F# 0 = optimum exposure The entire image receptor is sensitive to both incident and
scatter radiation.
1 = 2x required dose -1 = 1/2 the required dose
If you make an exposure in the room without using the
2 = 4x required dose -2 = 1/4 the required dose
detector, an acquisition may occur on the system resulting in
3 = 8x required dose -3 = 1/8 the required dose an unassigned image.
Please refer to the operator manual to assign unassigned
images or close Magellan acquisition interface before making
the exposure.

64
 D I G I TA L IMAGING GUIDELINES
Underexposure: An underexposed image will appear grainy (quantum mottle).

UNDEREXPOSURE

Check the Grid Was the appropriate

technique set?

Is the correct grid Was the anatomy centreed over

being used? the correct AEC chamber?

100 cm (40”) 180 cm (70”) Was the exposure Was the exposure
Focal Distance Focal Distance adjusted for body adjusted for patient
habitus? pathology?

Do not use grid

for extremities

65
 D I G I TA L IMAGING GUIDELINES
Overexposure: When an image or an area of an image has been overexposed, the overexposed area will appear completely black. You can
tell the image is overexposed if no image information is available, even when adjusting the contrast and brightness.

OVEREXPOSURE

Check the Grid Was the appropriate

technique set?

Is the correct Was the anatomy centreed over

grid in? the correct AEC chamber?

100 cm (40”) 180 cm (72”) Was the exposure Was the exposure
Focal Distance Focal Distance adjusted for body adjusted for patient
habitus? pathology?

Do not use grid

for extremities

66
D I G I TA L IMAGING GUIDELINES

These pictures were taken for positioning demonstration only.

In clinical practice, proper shielding should always be used.
For more information, please refer to your operator’s manual
or call your representative.
Imaging Dynamics Company Ltd.
151, 2340 Pegasus Way N.E.
Calgary, Alberta, Canada
www.imagingdynamics.com